C09980060 / invoice 10000

Consultation Time: 3:15pmHospital Time Period: History:Nanuq presented to GreenCross Point Cook on 02 March, performed abdominal x-ray with sedation. Dispensed lactulose and anti-nausea medications (Odansetron).Yesterday night whinning, chasing birds and rabbits continously all night long, had couples decent poop. 8am had diffculty pooping, 3ml laxatives given instead of the recommended 5ml. Struggling to poop, straining, scotting on the ground, crying when pooping. Yellow semi-solid faeces yesterday night. Liquid dirrhoea (yellow mucoid coloured) at 14:00 after given the laxatives at 8am. On bland diet with broiled chicken since last night, Nanuq interested in broiled chicken/ rice but not kibbles. Constipated since friday/ saturday (3-4 days). Fisrt time behavioral change, energy level increased and decreased. At the beach two weeks ago after the deworming. O said: it has an apptitie, just not interested in kibbles. O gave Anti-nausea tablets last nigth trying to improve appetite in kibbles. Nauq tries to eat eveything on walk/ around the house, does scavenge , not all the time (grass/ roots/ weeds/ furnitures/ toys)Presenting complaint: Dirrhoea Last normal:EDDU: drinking normal, urination normal Vomiting/diarrhea: occasional vomitting (throwing up the cardboard) Last eaten: 8am 03/03Pre-existing conditions:Medications: NoAllergies: NoVaccination: UTDParasite control:UTD (two weeks ago)Travel history: NoDiet: RC kibbles, bland broiled chicken and ricePotential toxin exposure: none at home but known scavenger Other pets: Another 12Yo husky , every pet in the household healthy, UTD with vax and deworm. Regular vet:Subjective:Objective:Temp:            MM: pink/ moist             CRT:    <2s         HR:    120         FP:   S&S           RR: 40BCS:   5 /9                Wgt:  27.7  kg Pain Score (CSU):   /4CV:    RESP:              GIT: Tense on caudal abdomen, whinning on palpation. Unable to perform rectal exam (but performed at GS Pointcook on 02March under sedation) or rectal temp.U/G:  Bladder soft on palpation, both testicles descended.Neuro:  BAR, responsive to the enviornment, stiffing around the room. Normal gait and posture. Ambulatory x4M/S:  Good muscle condition.Integ:  Coat shiny and smooth. Ophth:  Clear , symmetrical bilaerally, no dischargeLNs: Submandibular/ prescapular/ popliteal LNs all normal Initial Tests:INTERNAL LABORATORYPCV/TS:(Dog: PCV 37-55%, TS 55-75 g/L)(Cat: PCV 30-45%, TS 62-81 g/L)LACTATE:   mmol/L	Blood Gas(sample type: arterial/venous)Abnormal parameters:Interpretation:CBCAbnormal parameters:Blood smear examination:BiochemistryAbnormal parameters:PT:APTT:UrinalysisCollection method: cystocentesis/urinary catheter/free catchpH:   Protein:   Glucose:   Ketones:   Urobilinogen:   Bil:   Ery:   Hb:USG:Sediment examination:EXTERNAL LABORATORYLab No: 	***** PENDING *****Sample: Interpretation:IMAGINGAFAST:TFAST/Vet Blue:Radiography:Problem List: Tentensmus, acute dirrhoea (after lactulose), hyporexia , inappetence, caudal abdominal pain, hyperactivitiy possibly related to pain. Known scavenger. Assessment: Options Offered to Client:01: Administer anti-emetic injection at clinic. Withold lactulose, continous odansetron. Continous with blend diet (broiled chicken and rice) or commerical low fat diet.02: RV for abdominal US, bloodwork (CBC, Biochem, electrolytes, basal cortisol)03: Consider hypoallergenic diet trial in the future.Financial update (deposit, estimate communicated):Referring Vet Communication: Treatment:  	Plan: Diagnostic plan :Therapeutic plan :Discharge plan :Referral plan :    Vital Signs